Mapping Zika virus disease incidence in Valle del Cauca.

OBJECTIVE: Geographical information systems (GIS) use for development of epidemiological maps in tropical diseases is increasingly frequently utilized. Here, we apply this technique to map the current Zika virus (ZIKV) outbreak in Colombia. METHODS: Surveillance cases data of the ongoing epidemic of ZIKV in Valle del Cauca department and its capital, Cali (2015-2016), were used to estimate cumulated incidence rates (cases/100,000 population) to develop the first maps in the department and it municipalities. The GIS software used was Kosmo Desktop 3.0RC1®. Three thematic incidence rate maps were developed. RESULTS: Up to April 2, 2016, 9,825 cases of ZIKV were reported (15.15 % of the country cases). The burden of ZIKV infection has been concentrated in the North of the department. Valle del Cauca borders with other departments with incidence of ZIKV infection, such as Quindío (173 cases) and Risaralda (687 cases). Eleven municipalities of Valle del Cauca had cases in the range between 250 and 499 cases/100,000, all in the North and East of the department. Cali, the capital concentrates more than a third of the reported cases of ZIKV in Valle del Cauca. CONCLUSIONS: Use of GIS-based epidemiological maps allows to guide decision-making for prevention and control of diseases that constitute significant public health problems in the region and the country, such as exemplified by the emergence of ZIKV infection, particularly in departments such as Valle del Cauca with a high disease incidence.

The rs483145 polymorphism of MC4R gene is not associated with obesity in the Chilean population: Results of GENADIO study.

INTRODUCTION: The melanocortin receptor 4 (MC4R) participates in the control of appetite at the level of the central nervous system, through the leptin-melanocortin pathway. An association between different polymorphisms of the MC4R gene and obesity has been reported. However, there are few studies of the rs483145 single nucleotide polymorphism (SNP) of this gene. OBJECTIVE: To investigate its prevalence and association with adiposity markers in Chilean adults. METHODS: The prevalence of SNP rs483145, of the MC4R gene, was determined in 259 participants of the GENADIO study (genes, environment, diabetes and obesity) by means of real-time polymerase chain reaction (PCR). The association between the risk allele of MC4R (A) and adiposity markers (body weight, body mass index, fat mass percentage, hip circumference, waist circumference, waist-to-hip ratio) was performed by linear regression analysis and adjusted for confusion variables (socio-demographic and physic activity) using three statistical models. RESULTS: It was determined that the prevalence of the risk allele (A) of the SNP rs483145 of the MC4R gene is 24.5% in the Chilean adult population included in this study, without finding an association with any of the adiposity markers studied, both in adjusted and unadjusted models. CONCLUSION: The presence of the risk allele of SNP rs483145 of the MC4R gene is not associated with adiposity markers in the Chilean adult population studied. New studies with a bigger sample size will be necessary to confirm these results.

The rs483145 polymorphism of MC4R gene is not associated with obesity in the Chilean population: Results of GENADIO study. / El polimorfismo rs483145 del gen MC4R no se asocia con obesidad en población chilena: resultados del estudio GENADIO.

INTRODUCTION: The melanocortin receptor 4 (MC4R) participates in the control of appetite at the level of the central nervous system, through the leptin-melanocortin pathway. An association between different polymorphisms of the MC4R gene and obesity has been reported. However, there are few studies of the rs483145 single nucleotide polymorphism (SNP) of this gene. OBJECTIVE: To investigate its prevalence and association with adiposity markers in Chilean adults. METHODS: The prevalence of SNP rs483145, of the MC4R gene, was determined in 259 participants of the GENADIO study (genes, environment, diabetes and obesity) by means of real-time polymerase chain reaction (PCR). The association between the risk allele of MC4R (A) and adiposity markers (body weight, body mass index, fat mass percentage, hip circumference, waist circumference, waist-to-hip ratio) was performed by linear regression analysis and adjusted for confusion variables (socio-demographic and physic activity) using three statistical models. RESULTS: It was determined that the prevalence of the risk allele (A) of the SNP rs483145 of the MC4R gene is 24.5% in the Chilean adult population included in this study, without finding an association with any of the adiposity markers studied, both in adjusted and unadjusted models. CONCLUSION: The presence of the risk allele of SNP rs483145 of the MC4R gene is not associated with adiposity markers in the Chilean adult population studied. New studies with a bigger sample size will be necessary to confirm these results.

GLUT1 and GLUT8 support lactose synthesis in Golgi of murine mammary epithelial cells.

The mammary gland increases energy requirements during pregnancy and lactation to support epithelial proliferation and milk nutrients synthesis. Lactose, the principal carbohydrate of the milk, is synthetized in the Golgi of mammary epithelial cells by lactose synthase from glucose and UPD galactose. We studied the temporal changes in the expression of GLUT1 and GLUT8 in mammary gland and their association with lactose synthesis and proliferation in BALB/c mice. Six groups were used: virgin, pregnant at 2 and 17 days, lactating at 2 and 10 days, and weaning at 2 days. Temporal expression of GLUT1 and GLUT8 transporters by qPCR, western blot and immunohistochemistry, and its association with lactalbumin, Ki67, and cytokeratin 18 within mammary tissue was studied, along with subcellular localization. GLUT1 and GLUT8 transporters increased their expression during mammary gland progression, reaching 20-fold increasing in GLUT1 mRNA at lactation (p < 0.05) and 2-fold at protein level for GLUT1 and GLUT8 (p < 0.05 and 0.01, respectively). The temporal expression pattern was shared with cytokeratin 18 and Ki67 (p < 0.01). Endogenous GLUT8 partially co-localized with 58 K protein and α-lactalbumin in mammary tissue and with Golgi membrane-associated protein 130 in isolated epithelial cells. The spatial-temporal synchrony between expression of GLUT8/GLUT1 and alveolar cell proliferation, and its localization in cis-Golgi associated to lactose synthase complex, suggest that both transporters are involved in glucose uptake into this organelle, supporting lactose synthesis.

Mapping the residual incidence of taeniasis and cysticercosis in Colombia, 2009-2013, using geographical information systems: Implications for public health and travel medicine.

BACKGROUND: In Colombia, taeniasis and cysticercosis have been significantly reduced over the past decades, however still reported with implications for public health and travel medicine. METHODS: An observational, retrospective study, in which the incidence of taeniasis and cysticercosis (ICD-10 codes B68s/B69s) in Colombia, 2009-2013, was estimated based on data extracted from the Individual Health Records System (Registro Individual de Prestación de Servicios, RIPS) was performed. The Geographic Information System (GIS) generated national maps showing the distribution of taeniasis and cysticercosis by department by year. RESULTS: During the period, 3626 cases were reported (median 796/year), for a cumulative crude national rate of 7.7 cases/100,000pop; 58.2% corresponded to male; 57% were <40 year-old (10.2% < 9.9 year-old). Cases were 57.6% neurocysticercosis, the rest were taeniasis due to T. solium, T. saginata, ocular cysticercosis and cysticerci in other organs. Bolivar, a touristic department, had the highest cumulated incidence rate (16.17 cases/100,000pop), as also evident across the map series developed in this study. CONCLUSION: Despite the limitations of this study, data presented provide recent estimates of national taeniasis and cysticercosis incidence in the country useful in public health and for travel medicine practitioners, as some highly touristic areas presented higher disease incidence. Improved control, particularly of taeniasis, should be an attainable goal, which among other strategies would require improved sanitation and health education to prevent transmission, but also enhanced surveillance.

Post-chikungunya chronic inflammatory rheumatism: Follow-up of cases after 1 year of infection in Tolima, Colombia.

INTRODUCTION: Chronic Inflammatory Rheumatism (CIR) is one of the recognized and increasingly reported consequence post-chikungunya infection (pCHIK) in Colombia and Latin America. METHODS: Retrospective cohort study of 128 patients with CHIK that persisted with pCHIK-CIR after 59-68 weeks (1.13-1.31 years). This information was evaluated by means of a telephone survey and according to validated criteria (WHO 2015) previously (patients with >12 weeks post-CHIK with ≥1 manifestations [continuous/recurrent]: chronic polyarthralgia [pCHIK-CPA], stiffness and/or joint edema). RESULTS: Of the total CHIK-infected subjects finally included (n = 65), 28 (43.1%) reported pCHIK-CPA; and 38 patients (58.5%) at least one persistent rheumatological symptoms over the last year (pCHIK-CIR); 38.5% of them, morning stiffness, 18.5% joint edema, and 3.1% joint redness. No significant sex differences were found; 60% of patients with pCHIK-CPA aged> 40 years (RR = 3.75; 95%CI 1.47-9.53). The 29.2% of patients required medical attention because of symptoms. CONCLUSIONS: Nearly half of patients with CHIK had at least one rheumatologic symptom persistent over a year, and the third of them, pCHIK-CPA. These results are comparable with previous estimates obtained in other cohorts in the country (Risaralda and Sucre) and are consistent with results from other studies in France and India.

Mapping the ecoepidemiology of Zika virus infection in urban and rural areas of Pereira, Risaralda, Colombia, 2015-2016: Implications for public health and travel medicine.

OBJECTIVE: Geographical information systems (GIS) have been demonstrated earlier to be of great use to inform public health action against vector-borne infectious diseases. METHODS: Using surveillance data on the ongoing ZIKV outbreak from Pereira, Colombia (2015-2016), we estimated incidence rates (cases/100,000 population), and developed maps correlating with the ecoepidemiology of the area. RESULTS: Up to October 8, 2016, 439 cases of ZIKV were reported in Pereira (93 cases/100,000 pop.), with highest rates in the South-West area. At the corregiments (sub-municipalities) of Pereira, Caimalito presented the highest rate. An urban area, Cuba, has 169 cases/100,000 pop., with a low economical level and the highest Aedic index (9.1%). Entomological indexes were associated with ZIKV incidence at simple and multiple non-linear regressions (r2 > 0.25; p < 0.05). CONCLUSIONS: Combining entomological, environmental, human population density, travel patterns and case data of vector-borne infections, such as ZIKV, leads to a valuable tool that can be used to pinpoint hotspots also for infections such as dengue, chikungunya and malaria. Such a tool is key to planning mosquito control and the prevention of mosquito-borne diseases in local populations. Such data also enable microepidemiology and the prediction of risk for travelers who visit specific areas in a destination country.

Diagnóstico final de pacientes con sospecha de accidente cerebrovascular descartado. Experiencia del Hospital de Chillán, chile / Final diagnosis of patients with suspect of ruled out stroke. experience of the Hospital of Chillán, Chile

INTRODUCCIÓN: El accidente cerebrovascular (ACV) es una lesión neurológica aguda con dos subtipos clásicos (isquémico y hemorrágico); siendo un importante problema de salud púbica en Chile. Existen patologías que imitan su presentación, sin embargo, una historia clínica y examen físico orientado permiten discriminar en un alto número de casos entre estas patologías evitando la derivación a especialista y solicitud de exámenes imagenológicos, disminuyendo así, los costos derivados en un gran número de pacientes. MATERIAL Y MÉTODO: Estudio transversal a partir de las fichas clínicas de pacientes ingresados con sospecha de ACV durante febrero y marzo del 2016 en Hospital Clínico Herminda Martín de Chillán para su confirmación diagnóstica por el Servicio de Neurología. RESULTADOS: Se obtuvieron 304 fichas clínicas con sospecha de ACV de las cuales un 26,9% no correspondieron a ACV. De estos, 45,9% eran patologías de especialidades no neurológicas siendo las más frecuentes las derivadas de Medicina Interna. DISCUSIÓN: El ACV es una entidad neurológica clásicamente descrita en base a la ubicación de la lesión vascular. Pese a que su presentación semiológica es conocida, existen muchas patologías que son clínicamente similares, o bien, las características singulares de los pacientes hacen que el patrón clínico sea confuso. Este fenómeno se refleja en una tasa de falsos ACV relativamente similar entre diferentes centros de salud. La tasa de error en diagnóstico de ACV en el estudio es de 26,9%, similar a otras experiencias. Pareciera ser que existe un número basal de falsos ACV, cuyo margen de error clínico, resulta difícil reducir aún con buenas escalas y protocolos estandarizados de atención.

INTRODUCTION: Stroke is an acute neurological lesion with two classic subtypes (ischemic and hemorrhagic), being an important public health problem in Chile. There are pathologies that mimic its presentation, however, a clinical history and oriented physical examination allow to discriminate in a high number of cases between these pathologies avoiding the referral to specialist and request of imaging examinations, thus reducing, the costs derived in a large number of patients. MATERIAL AND METHOD: Cross-sectional study from the clinical records of patients admitted with suspected stroke during February and March of 2016 at Herminda Martin Clinic Hospital from Chile for diagnostic confirmation by the Neurology Service. RESULTS: A total of 304 clinical files were obtained with suspected stroke, of which 26,9% did not correspond to stroke. Of these, 45,9% were pathologies of non-neurological specialties, the most frequent being those derived from internal medicine. DISCUSSION: Stroke is a neurological entity classically described based on the location of the vascular lesion. Although its semiologic presentation is known, there are many pathologies that are clinically similar, or the unique characteristics of the patients make the clinical pattern confusing. This phenomenon is reflected in a relatively similar false stroke rate among different health centers. The error rate in diagnosis of stroke of this study is 26,9%, similar to other experiences. It appears that there is a basal number of false stroke, whose clinical margin of error is difficult to reduce even with good scales and standardized care protocols.